Shakiness with dosage increase..

[Meds38]

Hi again all,
Just a quick one.. gone up to 25mgs (4th day ) and have noticed 2-3hrs later I may get woozy and shaky.. though my heart rate is fine and I don't feel anxious. I am prone to low blood sugar if I don't eat which will produce the same feeling.. I did read somewhere that Zoloft can affect your blood glucose levels..
Is this a side effect of the tablets.. kinda assume it is.. not a stranger to feeling shaky.. but its not something I commonly get, and have noticed this "rattly" feeling much more in the last month since taking these meds. Is this something I just need to ride out, and will it happen every time I increase my dosage? Hubby said that increase of dose in a drug is like starting for the first time regarding the side effects.. is that true? (He has been on tegretol for many years and more recently Keppra for seizures).
Thanks

[mele48]

I know it's tough!  

First off, I'm not a medical pro, so I can't comment on if zoloft causes muscle pain or will increase metabolism.

What I do know: our bodies experience anxiety as a chemical - the same "fight or flight" chemical.  And our bodies consider that a "working" chemical, designed to protect us by preparing us to fight or run away from a threat.  What's hard is since we're not "working" - or using the chemical - our body thinks it needs more of it to do the "fight or flight" thing.  So anxiety challenges can quickly become a tough cycle.  

All this "working" will cause our body to burn fuel faster, the same as non-anxiety stress or illness.  Beware of eating all carbs - I learned that the hard way!  Your body will burn through those fast fuels super fast and your blood sugar will get lower - - which also contributes to anxiety.  Ick, right?  Make sure your drinking plenty of fluids and eating protein/carb combinations.  Eat small snacks throughout the day - this will help keep your blood sugar at a more consistent level.  Avoid caffeine - that's another stimulant that will amp you up more.

As to the side effects - trust me, I feel your pain on this one.  I KNOW it's hard, but it's just one of those crummy things we have to ride out.  I'm on 6 of an increased dose, and I'm finally starting to taper off on my side effects.  Do what you need to to help you cope.  I baked my little heart out this weekend and spent some quality time with precious friends where I felt safe.  Certainly keep your doctor informed of your side effects.

I know what you mean about feeling close to being you but not quite....but you'll get there.   Be kind to yourself, and remember that you're dealing with a lot right now.  Hang in there!

[Meds38]

Hi,
Argh.. So 6th day since dosage increase and I'm still feeling on edge. I never know if it is because I need more of the Zoloft or if its the meds making me feel this way! I take them in the morning because they used give me insomnia, but fortunately that has settled down.
Can you tell me does this med usually cause muscle pain.. I have not had so many mild aching muscles since starting this medication!! It seems to exaggerate any pre-existing issues.. I have slight carpel tunnel.. now my wrists will ache here and there continually! Is this likely to be a lasting side-effect? I also have a mild headache.. the doctor said I can take my magnesium supplements again.. and I have been doing so but only at 300mgs, I used to take 600mgs daily.. I'm not sure if I can go back up to the higher dose, I don't think he considers it to be a problem with the Zoloft.
The way I feel on this medication is so odd.. I'm so much better, yet I'm not.. my head Is clearer.. and I don't have many fixating thoughts about my health etc.. yet I get shaky more, feel tense more.. argh.. But I'm also able to sit and watch tele without doing something.. I can just "be" .. for the first time in over a decade.. its so weird.
I have found that I get low on blood sugar quicker on these .. its sped my metabolism.. I get hungry now.. like stomach rumbling hungry.. haven't had that for a very long time..I've actually lost weight on these without much effort.. I'm not sure if the whole glucose level thing is an issue considering I'm not a diabetic.. does this kind of thing just go with the territory?
As you can see, I haven't had to take much medication in my life.. mainly the usual antibiotics and herbals the last decade.. so this "juggling" of side-effect vs benefit.. waiting.. etc.. is so foreign to me!
In short I'm sticking with it.. but part of me is still nervous about this whole thing.. how long until I will know that any shakiness/jittery feelings is my anxiety coming through and not the meds?
I am so happy I found this forum... Thankyou all for your help!

[nursegirl6572]

I wanted to add that sometimes changing your dosing time will help too.  I take my Zoloft at bedtime, which lessens any kind of "surge" I may feel in regard to side effects.  Always check with your doc first, but changing to a bedtime dosing routine shouldn't be an issue and it may help a little.

[mele48]

Nursegirl speaks the truth!  She's given me a lot of good encouragement.  I'm on day 65 of Zoloft, and have experienced the same thing you're going through.  I've been taking a slow & steady approach under my psychiatrist's recommendation: 12.5 for a few weeks, 25, 37.5, & just started on 50 a few days ago.  Each time I up'd, I'd feel a bump in side effects.  But just like nursegirl said, it was milder/shorter each time.

Hang in there!

[nursegirl6572]

I recently went back on Zoloft myself, and I can tell you that I experienced the start-ups side effects every time I bumped up my dose, but I can tell you that the longer I was on it, the quicker those side effects resolved for me after a dosage increase (and the milder they got with time).  

I too had that jittery "drank too much coffee" feeling side effect.  It's tough but give it some time.  I think that going up gradually is the way to go, I tolerated that very well.  I have been on 100mg for a couple of months now and just last week bumped up to 125 mg and only had the side effects for maybe a day or so, and they were very very mild.  Definitely MUCH less severe than the side effects I experienced when I FIRST started the Zoloft.

I found it helpful to take advantage of that jittery feeling, and I kept myself very busy, cleaning, cooking, etc.  That helped a lot to take the edge off that jittery/shaky feeling, PLUS the bonus of getting things done was nice too!

Try to hang in there and let us know how you're doing!

[Meds38]

Hi,
I've actually been on the Zoloft for about a month all up and started on 12.5mgs. I've eased myself up very gradually to the current dosage.  I am wondering if every time I increase the dosage I will get side effects?
Thanks,

[specialmom]

Hi there and welcome.  So, you have been on Zoloft total for 4 days and are on 25 mg?  To ease your mind, that is an extremely low dose with most being on over 100 mg.  What you are experiencing are transient or 'start up' side effects.  I don't think it is low blood sugar that you are experiencing but you can always get that checked.  Shakyness can happen as these types of drugs are introduced.  But it should go away fairly quickly.  

If the side effects become unbearable, then you should talk to your doctor.  There are many medications to try and finding the right one can be a trial and error process.  However, it is best to do as you are doing, use a low dose and increase it slowly allowing the body to adjust.  And giving it enough time to see if it will work keeping in mind that many of the side effects are in the beginning and peter out as you get used to the drug.  

When anxious and depressed, it's worth it to get that under control.  good luck and peace